Provider Demographics
NPI:1417942343
Name:BEEM, GREG M (OD)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:M
Last Name:BEEM
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5505 EDMONDSON PIKE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-5869
Mailing Address - Country:US
Mailing Address - Phone:615-331-8688
Mailing Address - Fax:615-331-2273
Practice Address - Street 1:5505 EDMONDSON PIKE
Practice Address - Street 2:SUITE 101
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-5869
Practice Address - Country:US
Practice Address - Phone:615-331-8688
Practice Address - Fax:615-331-2273
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN609T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN410045419OtherRAILROAD MEDICARE ASHLAND CITY
TN410047739OtherRAILROAD MEDICARE NASHVILLE
TN410045419OtherRAILROAD MEDICARE ASHLAND CITY
TNT61150Medicare UPIN
TN3593703Medicare PIN
TN4494830001Medicare NSC